The best answer is B: No.

Here's Why: Once your contract to provide health care services to a patient has been terminated (whether by the patient or by their legally empowered agent), they not only have removed your authority to treat, they have also removed your legal duty to treat. In this case, they would have no legal basis to take action against you. On the other hand, if your services were terminated, and you decided to ignore the termination and continue to treat the patient anyway, several causes of action against you might be created.

The best answer is B: defibrillation.

Here's Why: When ventricular fibrillation occurs in the monitored patient, no time should be wasted on anything other than terminating the arrhythmia. Immediate defibrillation is required. When initial attempts at defibrillation fail, quality CPR should be administered while advanced airway management occurs and drugs are administered. Lidocaine does not enhance the ability to treat refractory ventricular fibrillation; however, it may be helpful in preventing re-induction. The routine use of lidocaine is not indicated.

The best answer is B: (2,3).

Here's Why: Atropine works by altering vagal tone that may increase the rate of sinus discharge and enhance conduction through the AV node. Most children with symptomatic complete heart block have disease below the AV node, thus atropine has no ability to speed infranodal escape pacemakers. However, once oxygen has been ruled out, atropine is an agent that can accelerate sinus node rate. This is specifically true when the bradycardia is caused by increased parasympathetic tone (e.g., caused by invasive procedures, etc.). The majority of pediatric patients who have had artificial pacemakers inserted have disease below the AV node, making atropine ineffective. In such a case, epinephrine would be a wiser choice of drug therapy. (A transcutaneous cardiac pacemaker would be an even better choice, if available).

The best answer is D: All of the above.

Here's Why: Arrhythmias caused by anomolous circuitry (e.g., regular R-R SVTs, VT and atrial flutter) typically respond to low energy. Atrial fibrillation and ventricular fibrillation most often require much higher levels in order to electrically depolarize a critical mass of fibrillating muscle.

The best answer is D: Both B and C.

Here's Why: Vagal maneuvers and adenosine are the recommended first interventions when treating stable PSVT. The most recent guidelines state that vagal maneuvers convert about 25% of patients with PSVT. If adenosine fails, the use of beta blockers or calcium channel blockers is recommended. While amiodarone may be indicated, its use should be employed by expert practitioners rather than as a routine consideration.

The best answer is D: Cardiologist electrophysiologist.

Here's Why: The cardiology sub-speciality trained to conduct cardiac electrophysiology studies such as intra-chamber electrograms is the Electro-Physiologist (EP). Most practice in a specialty EP lab.

The best answer is: D, All of the above

Here's Why: All of the listed signs and symptoms are related to perfusion failure (shock).

The best answer is D: All of the above.

Here's Why: Virtually all drugs that can be given IV can also be administered via the intraosseous route. The major exception is adenosine. This drug needs to reach the heart within milliseconds of injection, which could not happen when injecting the bolus into bone marrow.